Cardiology

Vascular Neurology

Questions discussed in this category

Can bleeding risk when switching from VKA treatment to a NOAC in frail, elderly patients be accurately compared if individual times in therapeutic range while on VKA treatment are not captured?

Individual times in the therapeutic range while on VKA treatment was not registered in FRAIL-AF.

2 Answers available

What is your approach to secondary stroke prevention in patients with atrial fibrillation and intracranial stenosis (>70%)?

3 Answers available

Would you change an elderly, frail patient with atrial fibrillation who is already on a NOAC to VKA treatment?

In FRAIL-AF, switching VKA therapy to a NOAC was associated with higher risk of bleeding in elderly, frail patients.

4 Answers available

Do you consider bleeding risk in elderly, frail patients with atrial fibrillation to be similar for all NOACs?

In FRAIL-AF, participants were switched from VKA to dabigatran, rivaroxaban, apixaban, and edoxaban.

2 Answers available

Do you think that home INR monitoring is a feasible option for elderly, frail patients with atrial fibrillation on VKA treatment, given variations in socioeconomic status and access to care?

2 Answers available

Do you usually recommend PFO closure for patients with frequent migraines with aura?

1 Answer available

How do you approach a patient with atrial fibrillation on apixaban who has a new cardioembolic stroke?

3 Answers available

In patients with Afib on anticoagulation and concurrent intracranial atherosclerotic disease, would you consider adding an anti-platelet to anticoagulation if there are recurrent events that could be related to the ICAD?

1 Answer available

Does the presence and location of cerebral microbleeds affect your decision for antithrombotic treatment in patients with atrial fibrillation?

Do you distinguish between primary and secondary prevention? Wilson et al., PMID 31130428 is helpful, but curious how people apply this data in practi...

3 Answers available

Would you recommend PFO closure in patients >60 years old with presumed paradoxical embolism as their mechanism of stroke?

2 Answers available

Would you favor restarting anticoagulation or pursuing left atrial appendage closure in a patient with hemorrhagic stroke on anticoagulation for non-valvular atrial fibrillation?

3 Answers available

When do you start anticoagulation in a patient with cardioembolic CVA secondary to new onset atrial fibrillation with hemorrhagic conversion?

1 Answer available

How does evidence of cerebral amyloid angiopathy/microbleeds affect choices for secondary stroke prevention in patients with a history of ischemic stroke and atrial fibrillation?

How do you approach secondary stroke prevention for patients with ischemic stroke, atrial fibrillation, and signs of cerebral amyloid angiopathy/micro...

1 Answer available

Do you start anticoagulation in a patient with infective endocarditis who also has atrial fibrillation and stroke?

1 Answer available

For patients with atrial fibrillation on DOAC, when should they resume DOAC after a thalamic bleed without intraventricular bleed?

How does presence of intraventricular hemorrhage change your recommendations?

2 Answers available

When do you start anticoagulation for secondary prevention in patients with HFrEF and history of embolic strokes?

For a relatively young, medically compliant patient with HFrEF (EF<35%) and h/o embolic stroke, what is the consensus of starting AC for secondary ...

1 Answer available

When is the best time to consider left atrial appendage closure for secondary stroke prevention in patients with atrial fibrillation?

For example, with a Watchman device? What is the evidence behind this?

1 Answer available

When do you restart anticoagulation in patients with atrial fibrillation who just had an ischemic stroke?

1 Answer available

How do you determine the timing of anticoagulation for patients with large MCA strokes secondary to atrial fibrillation?

1 Answer available

Papers discussed in this category

Stroke, 2020 Aug 06

Anticoagulation Type and Early Recurrence in Cardioembolic Stroke: The IAC Study.

Ann Neurol, 2020 Aug 05

Anticoagulation Timing in Cardioembolic Stroke and Recurrent Event Risk.

J Am Coll Cardiol,

Prospective randomized evaluation of the Watchman Left Atrial Appendage Closure device in patients with atrial fibrillation versus long-term warfarin therapy: the PREVAIL trial.

The New England journal of medicine, 2012-05-17

Warfarin and aspirin in patients with heart failure and sinus rhythm.

The New England journal of medicine, 2018-10-04

Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease.

The New England journal of medicine, 2019-05-16

Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source.

Heart, 2019 Apr 08

Anticoagulation therapy in heart failure and sinus rhythm: a systematic review and meta-analysis.

The New England journal of medicine, 2013-03-21

Closure of patent foramen ovale versus medical therapy after cryptogenic stroke.

Neurology, 2013-08-13

An index to identify stroke-related vs incidental patent foramen ovale in cryptogenic stroke.

The New England journal of medicine, 2017-09-14

Long-Term Outcomes of Patent Foramen Ovale Closure or Medical Therapy after Stroke.

Circ Cardiovasc Interv, 2022 Jun 23

Transcatheter Closure of Patent Foramen Ovale in Older Patients With Cryptogenic Thromboembolic Events.

JAMA, 2021 Dec 14

Heterogeneity of Treatment Effects in an Analysis of Pooled Individual Patient Data From Randomized Trials of Device Closure of Patent Foramen Ovale After Stroke.

JAMA Neurol, 2020 Jul 01

Proposal for Updated Nomenclature and Classification of Potential Causative Mechanism in Patent Foramen Ovale-Associated Stroke.

JAMA Neurol, 2022 Nov 01

Association of Atrial Septal Aneurysm and Shunt Size With Stroke Recurrence and Benefit From Patent Foramen Ovale Closure.

Stroke, 2021 May 24

2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association.

JAMA neurology, 2019-04-01

Association of Apolipoprotein E With Intracerebral Hemorrhage Risk by Race/Ethnicity: A Meta-analysis.

Lancet Neurol, 2019 May 23

Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies.

JAMA Neurol,

Assessment of Incidence and Risk Factors of Intracerebral Hemorrhage Among Participants in the Framingham Heart Study Between 1948 and 2016.

Lancet Neurol, 2018 Jan 10

The Edinburgh CT and genetic diagnostic criteria for lobar intracerebral haemorrhage associated with cerebral amyloid angiopathy: model development and diagnostic test accuracy study.

Circulation, 2023 Aug 27

Safety of Switching from a Vitamin K Antagonist to a Non-Vitamin K Antagonist Oral Anticoagulant in Frail Older Patients with Atrial Fibrillation: Results of the FRAIL-AF Randomized Controlled Trial.

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